My approach to planning breast augmentation surgery is to try and establish a common ground between what a patient desires and what is surgically possible. There are so many factors that must be considered when planning this procedure. Before we even discuss the details of surgery, we must consider the physical health and emotional readiness of each patient. Once we establish that a patient is a good candidate for breast augmentation, I undertake a physical examination to determine the many characteristics that will determine the final surgical plan.
They include body type and existing breast shape and size. Details such as symmetry between the left and right side are very important. Almost every woman has some degree of asymmetry. How well this can be improved must be clearly understood.
The big question is size - what is the ideal volume that will give a woman the best look and satisfy her goals? I approach this by simply asking that very question – “What kind of look do you want?” Is it "curvy but average", "fairly generous", "as big as I can" or some other descriptive idea. Often a reference to bra size is helpful. Once I have a sense of what kind of change a patient would like, I can determine if it is surgically possible. If it is, we can discuss details such as implant type, incision location, scheduling for recovery etc. We collaborate to tailor a truly individualized surgical plan.
Sometimes patients will bring magazine or internet photos of the kind of result they would like. My advice is to bring photos of women who are fully clothed in clothing that fits snugly. We can get a better idea of the look we can achieve without the distraction of someone else’s breast shape influencing our conclusion.
The scope of planning at the clinic extends well beyond the actual surgery and includes the recovery period as well. I believe that I am the only plastic surgeon in the city to include an overnight stay with a private nurse as part of my post-operative management. The purpose of this policy is to ensure that each patient has optimum care in the important period immediately following surgery. A smooth and comfortable post-operative course greatly enhances the likelihood of a problem free recovery.
Planning an adequate period of "downtime" after surgery is a really important part of the process. I advise patients to take a week off and rest. Nothing strenuous, get help with the kids. After the first week, most patients are back at work and three weeks after surgery, they are back in the gym. The recovery period is not lengthy, but everyone needs time to heal.